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PREGNANT Short Cervix Trial
This study is currently recruiting participants.
Verified by Columbia Laboratories, February 2010
First Received: January 18, 2008   Last Updated: February 3, 2010   History of Changes
Sponsor: Columbia Laboratories
Collaborator: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by: Columbia Laboratories
ClinicalTrials.gov Identifier: NCT00615550
  Purpose

The purpose of this research study is to evaluate the usefulness of progesterone vaginal gel in decreasing the preterm birth rate in a population of pregnant women with short cervical length and at high risk for preterm birth.


Condition Intervention Phase
Preterm Delivery
Short Cervix
Short Uterine Cervical Length
Drug: progesterone
Drug: placebo
Phase III

Study Type: Interventional
Study Design: Prevention, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Parallel Assignment, Safety/Efficacy Study
Official Title: The Effect of Vaginal Progesterone Administration in the Prevention of Preterm Birth in Women With a Short Cervix [Vaginal Progesterone Bioadhesive Gel (Prochieve)® Extending Gestation A New Therapy for Short Cervix - Trial (PREGNANT Short Cervix - Trial)]

Resource links provided by NLM:


Further study details as provided by Columbia Laboratories:

Primary Outcome Measures:
  • Reduction in the frequency of preterm birth (less than or equal to 32 6/7 weeks gestation). [ Time Frame: Gestational age at delivery ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Reduction in the frequency of neonatal morbidities such as respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), proven sepsis, and necrotizing enterocolitis (NEC) [ Time Frame: Delivery date to 28 days ] [ Designated as safety issue: Yes ]
  • Reduction in the frequency of preterm birth at ≤27 6/7, ≤34 6/7, and <36 6/7 weeks gestation [ Time Frame: Gestational Age at Delivery ] [ Designated as safety issue: No ]
  • Reduction in the frequency of neonatal mortality [ Time Frame: Delivery date to 28 days ] [ Designated as safety issue: Yes ]
  • Reduction in the frequency of admission for preterm labor [ Time Frame: 20 0/7 weeks to 32 6/7 weeks gestation ] [ Designated as safety issue: No ]
  • Assessment of the admission-to-delivery interval in subjects receiving tocolytic therapy for preterm labor [ Time Frame: 20 0/7 weeks to 32 6/7 weeks gestation ] [ Designated as safety issue: No ]
  • Assessment of Apgar scores, length, weight, and head circumference at birth, and incidence of congenital anomalies [ Time Frame: date of delivery ] [ Designated as safety issue: No ]
  • Assessment of other indicators of neonatal morbidity such as admission to the NICU, the duration of stay in the NICU, and the total hospital stay [ Time Frame: date of delivery to 28 days ] [ Designated as safety issue: No ]

Estimated Enrollment: 450
Study Start Date: March 2008
Estimated Study Completion Date: October 2010
Estimated Primary Completion Date: October 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo: Placebo Comparator
placebo vaginal gel
Drug: placebo
vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation
Prochieve: Active Comparator
Progesterone 8% Vaginal Gel
Drug: progesterone
8% vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation

  Eligibility

Ages Eligible for Study:   15 Years to 45 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. The subject has a short cervical length by transvaginal ultrasound (TVU) defined as 10-20mm. In cases of "dynamic cervix", the shortest observed/documented cervical length by TVU is to be used as the cervical length for inclusion purposes.
  2. Singleton gestation.
  3. The pregnancy has an estimated gestational age between 19 0/7 weeks and 23 6/7 weeks.
  4. Maternal age between 15 (or local age of majority/emancipation) and 45 years of age at the time of screening. An alternative age range can be accepted according to the standards and applicable regulations of the study centers.
  5. The subject speaks either English or a common local language.
  6. The subject has voluntarily signed the Informed Consent Form and associated forms after having the contents explained, and all her questions are answered to her satisfaction and understanding.
  7. In the opinion of the investigator, the subject is able to understand the study and is able to give informed consent, as well as participate in it and adhere to study procedures.

Exclusion Criteria:

  1. The subject has a cervical length <10 or >20mm.
  2. The subject has a multifetal gestation.
  3. The subject has or is scheduled to have a cervical cerclage prior to randomization. According to ACOG Practice Bulletin Number 48 (November 2003), cerclage can be considered in a subject with a history of 3 or more unexplained midtrimester pregnancy losses or preterm deliveries.228,229
  4. Subjects diagnosed to have acute cervical insufficiency with bulging membranes passing the external os.
  5. The subject has a previous history of an adverse reaction to progesterone or any component present in Prochieve® 8% vaginal gel.
  6. The subject has been treated with a progestogen within the previous 4 weeks.
  7. The subject is currently being treated for a seizure disorder, has an unstable psychiatric disorder, is taking antihypertensive therapy for chronic hypertension at the time of enrollment, has a history of congestive heart failure or chronic renal failure, or has uncontrolled diabetes mellitus (known end-organ dysfunction secondary to vascular disease).
  8. The subject has active thrombophlebitis or a thromboembolic disorder, or a history of hormone-associated thrombophlebitis or thromboembolic disorders.
  9. The subject has active liver dysfunction or disease.
  10. The subject has known or suspected malignancy of the breast or genital organs.
  11. The subject is currently participating in another interventional study or has participated in an interventional drug study within one month prior to screening for this study.
  12. The subject's current pregnancy is complicated by a major fetal anomaly or known chromosomal abnormality.
  13. The subject has a uterine anatomic malformation (bicornuate uterus, septate uterus)
  14. The subject, in the judgment of the investigator, will be unable or unwilling to comply with study-related assessments and procedures.
  15. The subject currently has preterm rupture of membranes, vaginal bleeding, known or suspected amnionitis, or signs or symptoms of preterm labor at the time of enrollment.
  16. The subject is HIV positive with a CD4 count of <350 cells/mm3 and is receiving more than one (1) medication to prevent the transfer of AIDS to the fetus.
  17. Complete placenta previa.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00615550

Contacts
Contact: Joseph R. Parella, RN 973-486-8855 jparella@columbialabs.com

  Show 32 Study Locations
Sponsors and Collaborators
Columbia Laboratories
Investigators
Study Director: George W. Creasy, MD, FACOG Columbia Laboratories, Inc.
Study Director: Roberto Romero, MD Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study Director: Sonia Hassan, MD Wayne State University
  More Information

Additional Information:
Publications:
Responsible Party: Columbia Laboratories, Inc. ( George W. Creasy, MD, FACOG, VP Clinical Research )
Study ID Numbers: COL-1620-302, 09-CH-N014
Study First Received: January 18, 2008
Last Updated: February 3, 2010
ClinicalTrials.gov Identifier: NCT00615550     History of Changes
Health Authority: United States: Food and Drug Administration;   India: Drugs Controller General of India;   Israel: Ministry of Health;   Italy: Ethics Committee;   South Africa: Medicines Control Council

Keywords provided by Columbia Laboratories:
Preterm
Cervix

Additional relevant MeSH terms:
Pregnancy Complications
Progesterone
Progestins
Obstetric Labor, Premature
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Obstetric Labor Complications
Hormones
Pharmacologic Actions
Premature Birth

ClinicalTrials.gov processed this record on February 08, 2010